<!DOCTYPE html>
<html lang="en" xmlns:th="http://www.thymeleaf.org"
      xmlns:layout="http://www.ultraq.net.nz/thymeleaf/layout"
      layout:decorate="~{layouts/layout}">
  <head>
    <meta charset="utf-8">
    <title>新增电子病历模板</title>
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
  </head>
  <body>
    <th:block layout:fragment="content">
        <div class="span9">
            <div class="row-fluid">
                <div class="page-header">
                    <h1>新增电子病历模板</h1>
                </div>
                <form class="form-horizontal">
                    <fieldset>
                        <div class="control-group">
                            <label class="control-label" for="patients">病 人</label>
                            <div class="controls">
                                <select id="patients">
                                    <option value=""></option>
                                    <option value="1_张三">张三</option>
                                    <option value="2_李四">李四</option>
                                </select>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="emrTypes">病历类型</label>
                            <div class="controls">
                                <select id="emrTypes">
                                    <option value=""></option>
                                    <option value="inHospitalMr">入院病历</option>
                                    <option value="patientRecords">病程记录</option>
                                </select>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="emrTemplates">病历模板</label>
                            <div class="controls">
                                <select id="emrTemplates">
                                    <option value=""></option>
                                    <option value="1">住院病历模板</option>
                                    <option value="2">病程记录模板</option>
                                </select>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="depts">部 门</label>
                            <div class="controls">
                                <select id="depts">
                                    <option value=""></option>
                                    <option value="胃肠中心">胃肠中心</option>
                                    <option value="肺癌中心">肺癌中心</option>
                                </select>
                            </div>
                        </div>
                        <div class="form-actions">
                            <input type="submit" class="btn btn-success btn-large" value="保存" /> <a class="btn" th:href="@{emr-template-list}">Cancel</a>
                        </div>
                    </fieldset>
                </form>
            </div>
        </div>
    </th:block>
  </body>
</html>
